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SUMMARYThis report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis.KEY WORDS: Erysipelothrix, Endocarditis, Erysipeloid. CASE REPORTA 51-years-old white male was admitted to Hospital Mãe de Deus on November 30, spring of 1987, for evaluation of unexplained fever. He was a retired, mild alcoholic, who used to fish and cook as a hobby. On October 12, while cleaning some fish, he had gashed his left hand thumb, developing probable erysipeloid disease that was not detected at the time. Fifteen days later, his right foot showed signs of infection, with an erythematous lesion. His doctor prescribed corticosteroid and erythromicin for 2 days. Articular pain and astenia persisted and about 3 weeks later patient had sudden thoracic pain and a cough with ferruginous sputum. He was admitted to a hospital with a diagnosis of pneumonia and received daily doses of oxytetracycline while in the hospital. He was discharged on the seventh day but, as fever persisted, he went to Hospital Mãe de Deus. He reported feeling articular pain, dyspnea on effort and astenia. Several years earlier he had been told to have a heart murmur. When admitted, he had a fever of 37.6°C. Physical examination showed a well-fed man, with slightly discoloured mucous membranes; sistodiastolic aortic murmur + + /6; crepitation on the base of the right lung; no hepato or splenomegalies, no haemorrhagic suffusions; blood pressure 110/60 mmHg; bilateral pulmonar infiltration evident on chest X-ray; normal electrocardiogram; white blood cells count 5.000/cu.mm; normal differential count, haematocrit 32% and haemoglobin 10.2 mg/dl; erythrocyte sedimentation rate 112 mm/hr.

Introduction: The present study aimed to assess the antibiotic resistance profiles and detect the presence of the sul2 gene in sulfamethoxazole-susceptible and resistant isolates of Escherichia coli obtained from outpatients and inpatients with urinary tract infections. Methodology: The resistance profiles of 739 strains were assessed and the presence of the sul2 gene in 100 isolates was tested. Results: The antibiotics with the highest resistance rates were ampicillin (57.4%) and trimethoprim-sulfamethoxazole (44.7%). The presence of the gene sul2 was detected in 66.7% of outpatient samples and 67.9% of inpatient samples.Conclusions: Our results demonstrate that E. coli isolates exhibit high resistance to various classes of antibiotics, highlighting the need for developing strategies to help in prescribing antibiotics.

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RESUMOAvaliou-se um novo meio seletivo-indicador (ágar UNISC) para o isolamento de enteropatógenos clássicos e Aeromonas e Plesiomonas shigelloides. A capacidade de fermentação da xilose é indicada pela coloração amarela (fermentadores) ou azul (não fermentadores) que, aliada à prova da oxidase, constitui-se em indicador para a detecção de Aeromonas spp e Plesiomonas shigelloides. A produtividade e seletividade, avaliadas pelos índice de contagem absoluta e índice de contagem relativa indicam-no como uma alternativa aos coprocultivos clássicos porque permite, num só meio, o isolamento de Escherichia coli, Shigella spp, Salmonella spp, bem como, Aeromonas spp e Plesiomonas shigelloides, favorecendo o diagnóstico laboratorial das gastroenterites. Palavras-chaves:Aeromonas. Plesiomonas. Coprocultivo. Meio de cultura. ABSTRACTWe evaluated a new selective indicator medium (UNISC Agar) for isolation of classical enteropathogens, Aeromonas spp and Plesiomonas shigelloides. The xylose fermentation capacity is indicated by a yellow color (fermenting agents) or blue (no fermenting agent). This, together with the oxidase test, establishes it as an indicator for detecting Aeromonas and Plesiomonas shigelloides. Its productivity and selectivity, as assessed using the absolute count index and relative count index, indicate it as an alternative to the classical feces culturing media. This is because, in a single medium, it enables isolation of Escherichia coli, Shigella spp and and Salmonella spp, in addition to Aeromonas and Plesiomonas shigelloides, thereby favoring the laboratory diagnosis of gastroenteritis. Key

In a four-year period (July/2001-June/2005), 410 Haemophilus spp. isolates were studied. Those were isolated from sputum at Hospital Nossa Senhora da Conceição (NSC) in Porto Alegre city (RS). β β β β β-lactamase enzyme was detected in 113 (27.6%) of isolates through chromogenic cephalosporin method. Fifty-eight (51.3%) of them showed sensibility to ampicillin through disc-diffusion method using Haemophilus Test Medium (HTM) by NCCLS criteria. In 297 (72.4%) isolates β β β β β-lactamase was not detected by chromogenic cephalosporin method. Five (1.7%) of them were resistant and 1 (0.3%) intermediate to ampicillin using disc-diffusion method. The authors emphasized the importance of Haemophilus spp. resistance to ampicillin research in clinical laboratories routine and the use of more than one method for this analysis was proposed, due to different resistance mechanisms in Haemophilus spp.